Home based care improved glycaemic control and was cost effective in children with type 1 diabetes

Question Is a home based care programme more effective for glycaemic control and more cost effective than conventional hospital based
care in children with newly diagnosed type 1 diabetes mellitus?

Design

Randomised, unblinded, controlled trial with 3 years follow up.

Setting

An emergency department of a secondary and tertiary care paediatric teaching hospital in Montreal, Quebec, Canada.

Patients

63 consecutive children (mean age 10 y, 56% girls) who were newly diagnosed with type 1 diabetes, >2 years of age, living
at home and within 1 hour of the hospital, and who had no sibling with type 1 diabetes. Follow up was 100%.

Intervention

Within 72 hours of diagnosis, children were allocated to either home based care (n=32) or hospital based care (n=31). Children
allocated to home based care had insulin treatment and teaching at home by a diabetes treatment nurse; were admitted to hospital
for metabolic stabilisation if necessary; had flexibly scheduled, …